Active NPI
Holly Womack Primeaux, M.D.
- Family Medicine Physician
- Hattiesburg, MS
National Provider Identifier
1043451032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 000002352
- Practice address
- 6051 U S Highway 49
Hattiesburg, MS 39401-7200 - Phone
- (601) 288-7000
- NPI assigned
- Mar 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 00000000000 | LA | |
| Family Medicine Physician | 207Q00000X | 000002352 | MS | Primary |
Addresses
Primary practice location
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Mailing address
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone (601) 288-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000002352 | MS | MD | Family Medicine Physician |
| 00000000000 | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1043451032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6051 U S HIGHWAY 49",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017200",
"telephone_number": "601-288-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6051 U S HIGHWAY 49",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017200",
"telephone_number": "601-288-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMEAUX",
"first_name": "HOLLY",
"middle_name": "WOMACK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-20",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "00000000000",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "000002352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.